Individual
MRS. STACI WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5000 W CHAMBERS STREET, MILWAUKEE, WI 53210-1650
(414) 447-2550
Mailing address
5000 W CHAMBERS ST, MILWAUKEE, WI 53210-1650
(414) 447-2550
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1799027
WI
Other
Enumeration date
06/10/2008
Last updated
06/10/2008
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